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Asociación entre mayor cantidad de líquido cefalorraquídeo frontal y duración de la enfermedad en varones pero no en mujeres con esquizofrenia

Published online by Cambridge University Press:  12 May 2020

Vicente Molina
Affiliation:
Departamento de Psiquiatría, Hospital Clínico Universitario, Paseo de San Vicente, 58-182, 37007Salamanca, España
Javier Sanz
Affiliation:
Departamento de Psiquiatría, Hospital Doce de Octubre, Madrid, España
Fernando Sarramea
Affiliation:
Departamento de Psiquiatría, Hospital Reina Sofía, Córdoba, España
José M. Misiego
Affiliation:
Departamento de Psiquiatría, Hospital Clínico Universitario, Paseo de San Vicente, 58-182, 37007Salamanca, España
Carlos Benito
Affiliation:
Departamento de Neurorradiología, Hospital Gregorio Marañón, Madrid, España
Tomás Palomo
Affiliation:
Departamento de Psiquiatría, Hospital Clínico Universitario, Paseo de San Vicente, 58-182, 37007Salamanca, España
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Resumen

Objetivo

Se ha reconocido una cantidad mayor de líquido cefalorraquídeo (LCR) cortical como un posible marcador de una pérdida de sustancia gris. Esta cantidad mayor en la esquizofrenia se encuentra predominantemente en las regiones prefrontal y temporal. Planteamos la hipótesis de que la evolución global y la respuesta al tratamiento peores en los varones con esquizofrenia se relacionan con una pérdida mayor de volumen cortical comparado con las mujeres.

Sujetos y métodos

Para comprobar esta hipótesis hemos utilizado imágenes de resonancia magnética (IRM) para estudiar los valores de LCR cortical (prefrontal, temporal y hemisférico) en un grupo de 85 pacientes con esquizofrenia, 56 de los cuales eran varones y 29, mujeres. Calculamos los valores residuales de LCR en los pacientes a partir de los datos relativos a 45 sujetos de control y regresión lineal, de los que se descontaron los efectos normales de la edad y el volumen intracraneal. Estas puntuaciones residuales constituyen una medida cuantitativa de la cantidad mayor de LCR debida a la enfermedad.

Resultados

Los hombres, pero no las mujeres, presentaron una cantidad mayor significativa en el nivel de tendencia de LCR prefrontal izquierdo. Los valores residuales prefrontales y temporales se asociaban significativamente con la duración de la enfermedad en los varones, pero no en las mujeres.

Discusión

Estos resultados son compatibles con la peor evolución y la mayor gravedad de las anomalías estructurales encontradas por lo general en la esquizofrenia en los sujetos varones.

Conclusion

Nuestros datos apoyan la hipótesis de una pérdida cortical prefrontal acelerada en los varones, pero no en las mujeres con esquizofrenia.

Type
Artículo original
Copyright
Copyright © European Psychiatric Association 2005

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